Individual provider Active NPI

James Richard Maurin, DDS

  • General Practice Dentistry
  • West Allis, WI
National Provider Identifier
1063428241
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5001638-015 Issued in WI
Practice address
10401 W Lincoln Ave Ste 204
West Allis, WI 53227-1255
Phone
(414) 545-5380
Fax
(414) 545-0622
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5001638-015 WI Primary

Addresses

Primary practice location

10401 W Lincoln Ave Ste 204
West Allis, WI 53227-1255

Mailing address

10401 W Lincoln Ave Ste 204
West Allis, WI 53227-1255
Phone (414) 545-5380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5001638-015WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. James R. Maurin DDS SC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063428241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 W LINCOLN AVE STE 204",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271255",
            "telephone_number": "414-545-5380",
            "fax_number": "414-545-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 W LINCOLN AVE STE 204",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271255",
            "telephone_number": "414-545-5380",
            "fax_number": "414-545-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURIN",
        "first_name": "JAMES",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5001638-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.